title: The impact of post-mastectomy radiation therapy on male breast cancer patients--a case series.
abstract: OBJECTIVE
  To assess the impact of radiation management on male breast cancer (MBC) at London Regional Cancer Program (LRCP).
  
  
  METHODS
  Men with a diagnosis of breast cancer referred to LRCP were reviewed. The seventh American Joint Committee on Cancer staging system was used. Patients treated with and without post-mastectomy radiation therapy (PMRT) were analyzed. Disease-free survival (DFS) was defined as time duration from diagnosis to first recurrence. Overall survival (OS) was defined as time duration from pathologic diagnosis to death or last follow-up with any death defined as an event. Survival estimates were obtained using Kaplan-Meier methodology.
  
  
  RESULTS
  From January 1977 to December 2006, 81 men had invasive ductal carcinoma. The median age was 65 (range, 35-87 years). There were 15 Stage I, 40 Stage II, 20 Stage III, and 6 Stage IV patients. Median follow-up time was 46 months (range, 1-225 months). Of the 75 patients treated with curative intent, 29 did not receive PMRT and 46 completed PMRT. Patients who received PMRT demonstrated no benefit in overall survival (p = 0.872) but significantly better local recurrence free survival (p < 0.001) compared with those who did not receive RT. There was trend toward improving locoregional recurrence with PMRT in patients with high-risk features (node-positive, advanced stage, and ≤ 2 mm or unknown surgical margin). The median, 5-year, and 10-year disease-free survival and overall survival for the 75 patients were 77.7 months, 66.3%, 32.7%, and 91.2 months, 73.9%, and 36.6%, respectively.
  
  
  CONCLUSIONS
  The experience at LRCP suggests that high-risk MBC patients should consider PMRT to improve their chance of local recurrence-free survival.
authors.affiliation: Department of Radiation Oncology, London Regional Cancer Program, London Health Science Centre, University of Western Ontario, Ontario, Canada. edward.yu@lhsc.on.ca
authors.forename: Edward
authors.initials: E
authors.lastname: Yu
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Jawaid
authors.initials: J
authors.lastname: Younus
authors.forename: Tarek
authors.initials: T
authors.lastname: Elfiki
authors.forename: Larry
authors.initials: L
authors.lastname: Stitt
authors.forename: Gary
authors.initials: G
authors.lastname: Yau
authors.forename: Olga
authors.initials: O
authors.lastname: Vujovic
authors.forename: Francisco
authors.initials: F
authors.lastname: Perera
authors.forename: Michael
authors.initials: M
authors.lastname: Lock
authors.forename: Patricia
authors.initials: P
authors.lastname: Tai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000401:mortality / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000517:prevention & control; D009367:Neoplasm Staging; D011182:Postoperative Care